CMS Formulary

Displaying 122451-122460 of 1611142 results.
ID: 122451
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 122452
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122453
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122454
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122455
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122456
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122457
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122458
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 122459
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122460
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0